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Endocrine and metabolic aspects of COVID-19.

Endokrynologia Polska
January 1, 2021
Marek Pawlikowski et al. (2 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to explore the potential role of melatonin in mitigating age-related hormonal deficiencies that may contribute to COVID-19 morbidity/mortality in older individuals.

Results Summary

The study hypothesizes that melatonin, along with other hormonal deficiencies, may influence COVID-19 outcomes in older patients, suggesting its probable usefulness as an adjuvant therapy, though clinical trials are needed for confirmation.

Population

Older individuals with age-related hormonal deficiencies, particularly melatonin and dehydroepiandrosterone.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (7)
InterventionDirectionEndpointPopulationDosageImpactClaim #
SARS-CoV-2 binding to ACE2
decrease
ACE2 enzyme levels
-
-
leads to the downregulation
#1
SARS-CoV-2 binding to ACE2
increase
angiotensin II and aldosterone
-
-
leads to the excess
#2
ACEI and ARB
increase
COVID-19 infection outcome
-
-
could be presumed beneficial effects
#3
local RAS dysregulation in adipose tissue
increase
obesity as a risk factor of severe outcome
patients with COVID-19 infection
-
is the main cause of the negative role
#4
age-related hormonal deficiencies
increase
morbidity/mortality
older people
-
may contribute to
#5
melatonin
increase
COVID-19 infection outcome
-
-
usefulness as adjuvant drug is probable
#6
angiotensin converting enzyme inhibitors/angiotensin receptor 1 blockers
increase
COVID-19 infection outcome
-
-
usefulness as adjuvant drug is probable
#7
Abstract

The paper presents the theoretical considerations on the role of endocrine and metabolic alterations accompanying COVID-19 infection. These alterations may be presumed on the basis of the following two observations. Firstly, the virus SARS-CoV-2 responsible for the COVID-19 infection uses an important renin-angiotensin system (RAS) element - angiotensin-converting enzyme 2 (ACE2) - as a receptor protein for entry into target cells and, in consequence, disturbs the function of the main (circulating) renin-angiotensin-aldosterone system (RAAS) and of the local renin-angiotensin system localized in different tissues and organs. The binding of SARS-CoV-2 to ACE2 leads to the downregulation of this enzyme and, in the aftermath, to the excess of angiotensin II and aldosterone. Thus, in the later stage of COVID-19 infection, the beneficial effects of ACEI and ARB could be presumed. It is hypothesized that the local RAS dysregulation in the adipose tissue is the main cause of the negative role of obesity as a risk factor of severe outcome of the COVID-19 infection. Secondly, the outcome of COVID-19 strongly depends on the age of the patient. Age-related hormonal deficiencies, especially those of melatonin and dehydroepiandrosterone, may contribute to morbidity/mortality in older people. The usefulness of melatonin and angiotensin converting enzyme inhibitors/angiotensin receptor 1 blockers (the latter only in later phases of the infection) as adjuvant drugs is probable but needs thorough clinical trials.

Medical Subject Headings (MeSH)
AgingAldosteroneAngiotensin IIAngiotensin-Converting Enzyme 2COVID-19Diabetes MellitusHumansMelatoninObesityRenin-Angiotensin System
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality70/10
Citation Metrics
Total Citations4
Citations/Year1.0
Relative Citation Ratio0.37
NIH Percentile19.9%
Research Impact Scores
APT Score0.25
Weight Score2.13
Normalized Score0.60
Related Supplements
Endocrine and metabolic aspects of COVID-19. | Panacea Index